Study shows slow pay cycles for Medicare Part D script claims

WASHINGTON Documenting the slow pace of reimbursements to community pharmacies by the prescription drug plans administering Medicare Part D drug benefits, a new survey shows that pharmacies are waiting 30 days or more to be paid for a majority of the prescription claims filed under Part D.

The study, conducted by the University of Texas at Austin’s Center for Pharmacoeconomic Studies, found lengthy delays in pharmacy claims processing by many plans. Drawing from a database of 3 million Part D claims from 145 independent and 17 chain community pharmacies, researchers concluded that the median percentage of pharmacy claims that take over 30 days to be paid from the time they were submitted was 50.1 percent. Worse, reimbursement for 17.2 percent of those claims took over 60 days, the study found.

According to UT at Austin’s August, 2007 report, "Length of Prescription Drug Payment Times by Medicare Part D Plans," pharmacies commonly have to pay their suppliers every 15 days, yet the median percentage of claims that arrived in that time span was only 1.3 percent.

Responding to that report, two lawmakers friendly to community pharmacy have agreed to participate in a conference call by UT Sept. 6 to unveil the full results of the study. The two, Democratic Rep. Marion Berry of Arkansas and Rep. Walter Jones, a North Carolina Republican, authored the Fair and Speedy Treatment of Medicare Prescription Drug Claims Act of 2007, which has garnered nearly 200 cosponsors. The Senate version is S.1954, the Pharmacy Access Improvement Act of 2007. Both bills require complete and accurate Part D prescription drug claims submitted electronically be paid within 14 days, and paper claims within 30 days.

For more information, contact John Norton of the National Community Pharmacists Association, at 703-600-1174 or <a title="[email protected]" href="mailto:[email protected]" />[email protected].